Bulbul Emre, Gultekin Mehmet Hamza, Citgez Sinharib, Derekoylu Engin, Demirbilek Muhammet, Akkus Emre, Ozkara Hamdi
Department of Urology, Cerrahpasa Medical Faculty, University of Istanbul-Cerrahpasa, Istanbul, Turkey.
Andrology. 2022 Mar;10(3):560-566. doi: 10.1111/andr.13148. Epub 2022 Jan 4.
In the literature, there is not sufficient data on factors affecting the development of complications in patients with penile fracture after early surgical intervention.
To investigate the predictors of long-term complications in patients who underwent immediate surgical repair for penile fracture.
MATERIALS/METHODS: This clinical study included a total of 31 cases of penile fracture in which surgical treatment was performed within the first 24 h and penile fracture was confirmed during the operation. The patients with and without late complications were compared in terms of parameters such as age, tear size of the tunica albuginea of the penis, bilateral involvement of the corpora cavernosa involvement, urethral injuries, and duration from penile fracture to surgery.
The median age of the patients was 42 years (interquartile range: 34-51 years). The median time from penile fracture to surgery was 13 h (8-18 h). The median tear size was 16 mm (11-21 mm). Late complications were seen in 13 (41.9%) patients in the post-operative period. Erectile dysfunction developed in five (16.1%) patients in the post-operative period. There was no statistically significant relationship between age, tear size, time from penile fracture to surgery, and bilateral corporeal involvement in terms of erectile dysfunction development. Painful erections, penile deviations, urethral strictures, tunical scars, and re-fracture were the other late complications. There was a significant relationship between the development of any complication and time from penile fracture to surgery (p = 0.028) and tear size (p = 0.031). In the receiver operating characteristic analysis of complication development, the cut-off value for the time from penile fracture to surgery was 13.5 h.
We found that the longer time interval between penile fracture and surgery worsened the patient outcomes. In addition, tear size was determined to be a predictor for long-term complications. In our opinion, early treatment of penile fracture can prevent severe complications in these cases.
在文献中，关于早期手术干预后阴茎骨折患者并发症发生发展的影响因素，数据并不充分。
探讨接受阴茎骨折即刻手术修复患者长期并发症的预测因素。
材料/方法：本临床研究共纳入31例阴茎骨折患者，这些患者在受伤后24小时内接受了手术治疗，且术中证实为阴茎骨折。比较了有和没有晚期并发症的患者在年龄、阴茎白膜撕裂大小、海绵体双侧受累情况、尿道损伤以及从阴茎骨折到手术的时间等参数方面的差异。
患者的中位年龄为42岁（四分位间距：34 - 51岁）。从阴茎骨折到手术的中位时间为13小时（8 - 18小时）。中位撕裂大小为16毫米（11 - 21毫米）。13例（41.9%）患者在术后出现晚期并发症。术后有5例（16.1%）患者出现勃起功能障碍。在勃起功能障碍的发生方面，年龄、撕裂大小、从阴茎骨折到手术的时间以及海绵体双侧受累情况之间均无统计学显著关系。疼痛性勃起、阴茎弯曲、尿道狭窄、白膜瘢痕形成和再次骨折是其他晚期并发症。任何并发症的发生与从阴茎骨折到手术的时间（p = 0.028）和撕裂大小（p = 0.031）之间存在显著关系。在并发症发生的受试者工作特征分析中，从阴茎骨折到手术的时间的截断值为13.5小时。
我们发现阴茎骨折与手术之间的时间间隔越长，患者预后越差。此外，撕裂大小被确定为长期并发症的一个预测因素。我们认为，阴茎骨折的早期治疗可以预防这些病例中的严重并发症。
